Losing the Internal Oedipal Mother and Loss of Sexual Desire

This paper aims to examine how it might be possible to use psychoanalytic concepts to explore a deeper understanding of the difficulties with conscious and unconscious same gender sexual desires in psychoanalytic psychotherapy. The author explores how the loss of the unconscious oedipal mother can be manifested as a loss of sexual desire in a couple's relationship. The author suggests that the move from what is referred to as the longed‐for state of being in perfect harmony, to a more realistic state of imperfect harmony can bring about the recovery of an unconscious belief that one can possess the oedipal mother. The move from this fantasy state of merger to a more reality‐based relationship can induce feelings of abandonment and loss, particularly of sexual desire. The implications of this for the transference and countertransference, and the conscious and unconscious nature of erotic desires within the therapeutic relationship are considered. The importance of aspects of technique and the need for non‐pathologizing use of concepts to help clinicians more fully explore formulations and therapeutic interventions are examined. While this paper focuses on lesbian relationships, the relevance of the ideas presented here for other gender pairings is explored.     

Pregnancy and Sexual Relationships Study Involving wOmen and meN (PASSION Study)

IntroductionSexual satisfaction is believed to decrease during pregnancy; however, the effect of pregnancy on the sexual relationship in a couple is not well studied.AimTo assess for sexual dysfunction in heterosexual couples during pregnancy.MethodsWe performed a cross-sectional study of heterosexual pregnant women in the third trimester and their cohabitating partners.Main Outcome MeasuresSexual satisfaction in heterosexual couples during pregnancy was assessed with a self-reported questionnaire, the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) questionnaire.ResultsA total of 53 couples met eligibility criteria, and nearly all of those approached participated (52 of 53 couples). All couples were enrolled at or after 35 weeks’ gestation. The mean age was 29.0 ± 6.4 and 31.3 ± 6.9 years for women and men, respectively. 60% of couples were married, and the remainder were cohabitating and in a committed relationship. When analyzing the results of the GRISS questionnaire for both partners, a significant difference was seen in mean avoidance of sex between women and men (3.31 vs 2.63; P = .047) and non-sensuality (3.54 vs 2.75; P = .040). Women reported more of a decrease in communication about sex when compared with their partners (3.79 vs 3.23; P = .047). Vaginismus was more problematic during pregnancy than before (mean = 4.17), and frequency of intercourse was decreased (mean = 4.93) based on calculated GRISS scores.Clinical ImplicationsPregnant couples reported decreased frequency of intercourse and more pain with intercourse in women. Women were more likely to avoid intercourse and reported more problems with communication regarding sexual needs.Strength & LimitationsThis study is the first to assess both partners in pregnancy. Due to the nature of the study, we were unable to assess other factors affecting the relationship that may result in sexual dysfunction, there was no control group, and the results are limited to heterosexual couples.ConclusionOverall sexual satisfaction and function were not problematic for these couples during pregnancy based on the GRISS scale.Dwarica DS, Garbe Collins G, Fitzgerald C, et al. Pregnancy and Sexual Relationships Study Involving WOmen and MeN (PASSION Study). J Sex Med 2019;16:975–980.     

Penile prosthesis,sexual satisfaction and representation of male erotic value

A follow-up study conducted among 39 implanted patients and 30 partners shows that subject's satisfaction towards prosthetic-sexuality depends on their representation of male erotic value. The less satisfied patients are sensitive to a normative representation that associates erotic value to criteria of 'spontaneity', 'naturalness', 'tall and non-assisted erections'. Their main dissatisfaction likely derives from the insufficiency of a prosthetic solution to restore a male self-image based on such criteria. This induces a more important impact on satisfaction rates than do functional problems (e.g. difficulties in manipulating the device, unwanted deflations, uncomfortable sensations). These patients also show an attribution bias consisting in attributing erroneously the same dissatisfaction and negative attitude towards prosthetic sexuality to their partner. Therefore, in addition to surgery, a psychosexual support is necessary to modify erotic representations and to improve the communication between the partners in order to increase sexual satisfaction with prosthesis-assisted sexuality.     

Maternal Age,Paternal Age and New-Onset Hypertension in Late Pregnancy

Objective: To examine the association between maternal age, paternal age, and new-onset hypertension in late pregnancy. Methods: We carried out a retrospective cohort study of 9,302,675 pregnant women with live births in the United States between 1995 and 1998. Maternal and paternal ages were analyzed together using “couple age” in multivariate logistic regression models to reduce colinearity between maternal age and paternal age. The effect of paternal age was also analyzed with stratification of maternal age. Results: Compared with couples with both a maternal and paternal age of 20 to 34 years, an older maternal age (above 35 years) was associated with an increased risk for new-onset hypertension, except for couples with a very young father (below 20 years). Younger maternal age (below 20 years) was associated with a decreased risk for new-onset hypertension, except for couples with a very old father (above 45 years). There was no significant association between paternal age and new-onset hypertension with stratification of maternal age. Conclusion: Increased risk for new-onset hypertension in late pregnancy is significantly associated with advancing maternal age, whereas there is no association between paternal age and new-onset hypertension in late pregnancy.     

Learning to call the game: Some lessons from infant observation for the couple therapist

Abstract

Using a sports metaphor, this paper describes how infant observation may teach couple therapists to appreciate what is going on in front of their eyes, to learn to tolerate the disturbing, disquieting feelings that are evoked and, most importantly, to find a way to use these feelings when working with couples. It demonstrates how the experience of infant observation helps the couple therapist stay focused on the here-and-now experience within and between a couple and within and between the couple and the couple therapist. It emphasizes the importance of not getting lost in the content of the latest squabble – a commonly experienced difficulty in couple therapy – but rather to maintain quiet reflection in the face of the primitive anxieties kicked-up in couple treatment. Lastly, it argues for including infant observation in the training of couple therapists.     

Posttraumatic stress symptoms and postpartum depression in couples after childbirth: the role of partner support and attachment

Aim

The roles of partner attachment and perceptions of partner support were explored in relation to symptoms of posttraumatic stress and postpartum depression in couples within the first three postnatal months.

Methods

Participants (n = 372) were recruited within the first seven days postpartum, and completed questionnaire measures of trait anxiety, symptoms of acute posttraumatic stress, and perceptions of partner support. Postal questionnaires were completed at six weeks and three months, assessing attachment, perception of partner support, symptoms of posttraumatic stress, and postpartum depression. Two hundred and twelve couples completed all time-points.

Results

Results indicated that symptoms were significantly related within couples. Men's acute trauma symptoms predicted their partner's subsequent symptoms of posttraumatic stress. Less secure attachment and dissatisfaction with partner support were associated with higher levels of postpartum depression and posttraumatic stress.

Conclusions

Men's and women's responses following childbirth appear to be strongly interlinked; services should target both members of the dyad.